Topic Contents

Varicocele Repair for Infertility

Surgery Overview

Varicoceles are enlarged
varicose veins that occur in the
scrotum. They are fairly common, affecting 15 out of 100 men
overall and 40 out of 100 men with known
infertility.1 Varicoceles
occur most often in the left
testicle.

Varicocele repair is done
to improve male fertility. It can usually be done surgically on an outpatient basis using
local or general anesthetic. A small incision is made
in the abdomen close to where the testicles originally descended through the
abdominal wall. The veins that produce the varicocele are identified and cut to
eliminate blood flow to the varicocele.

Alternatively, a
nonsurgical procedure called percutaneous embolization
can be done to repair a varicocele. A small catheter is inserted through a
large vein in the groin or neck and advanced to the varicocele, which is then
blocked off by a balloon, coil, or medicine.

What To Expect After Surgery

Varicocele repair typically is done on
an outpatient basis. You can expect to go home within 4 hours of a routine
varicocele surgery. Pain medicine is prescribed for a few days after
surgery.

You should be able to resume light work duties 1 to 2
days after surgery and full strenuous activities within 1 week.

Why It Is Done

Varicoceles are thought to raise the
temperature of the testicles or cause blood to back up in the veins supplying
the testicles. Although the mechanism by which varicoceles affect fertility is
poorly understood, varicoceles seem to help damage or kill the sperm.1 Varicocele repair is typically done to improve the
fertility of men who have both a varicocele and impaired sperm.

How Well It Works

While some researchers have
observed that varicocele repair produces favorable pregnancy rates, others have
noted that these pregnancy rates are the same as the rates of couples who have
chosen not to have a varicocele repaired.2

Risks

Infection at the site of
surgery

Fluid buildup in the scrotum (hydrocele) that requires
draining

Injury to the arteries or nerves in the pubic area

What To Think About

There is no proof that fertility
rates improve after this surgery. But some doctors think that larger
varicoceles are linked to sperm problems. It is also possible that varicocele
surgery would improve the semen quality, making other fertility treatments
easier.2

Small varicoceles that are only
apparent with
ultrasound testing do not require repair.

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